小儿气管、支气管异物30例误诊原因分析

Analysis of misdiagnosis causes of 30 children with trachea or bronchial foreign bodies

目的探讨小儿气管、支气管异物在临床诊断中存在的问题。方法回顾性分析30例气管、支气管异物误诊患儿的临床资料,对误诊原因进行分析。结果本组30例患者误诊为支气管肺炎11例、支气管炎8例、右肺中叶综合征4例、支气管哮喘3例、右下肺大叶性肺炎2例、支气管扩张2例。均在基础麻醉下行直接喉镜或支气管镜下顺利取出异物。结论对反复的支气管炎、支气管肺炎、支气管哮喘、支气管扩张、肺气肿、肺不张、甚至肺脓肿治疗效果不佳的患儿,即使没有明确异物吸入史,均应怀疑有气管、支气管异物。

Objective To inquire into the issues that exist in the clinical diagnosis about foreign bodies in children trachea or bronchus. Methods To retrospective analysis of the clinical data about 30 children suffered from foreign objects in their tracheas or bronchi who were misdiagnosed and analysis of the misdiagnosis causes as well. Results Among these thirty cases, eleven children were misdiagnosed as bronchopneumonia, eight cases as bronchitis, four cases as the synthetical symptom in middle lobe of right lung, three cases with bronchial asthma, two cases with lobar pneumonia in lower lobe of right lung, and two children were misdiagnosed as bronchiectasis as well. These patients misdiagnosed were all successfully take out foreign bodies through the direct laryngoscope or bronchoscope with basal anesthesia. Conclusion The children suffered from repeated bronchitis, bronchopneumonia, bronchial asthma, bronchiectasis, pulmonary emphysema, atelectasis, even pulmonary abscess should be suspected as foreign bodies in their bronchi or tracheas if they couldn＇t get good thera- peutic effect though they didn＇t have the definite history of inhaling foreign objects.